History of total ankle replacement starts in the 70s as alternative procedure to arthrodesis, with the aim to resolve pain and restore motion. Our tradition starts in 1975, five years after Lord-Marotte ankle prosthesis, with the first generation model Pipino-Calderale. Starting from this experience we realized and implanted in 1998 a second generation model, custom-made Vittore-Simone. Starting point for development of both implants is an accurate study of instantaneous centres of rotation in normal and pathologic ankles, together with a finite element analysis. The demonstration that wide resections of talar dome, modifying the geometrical arrangement of trabeculae of cancellous bone, compromise the perfect balance of uniform distribution of forces, leads us to only remove articular cartilage of talar dome instead its resection, in order to preserve the structural and vascular integrity. Our replacement doesn’t preclude an eventual arthrodesis in case of implant failure. We have a 30 years follow-up for five Pipino-Calderale models and up to 10 years for ten custom-made Vittore-Simone. Results are good for both models with satisfaction of patients and improvement of AOFAS score. Two Pipino-Calderale presented a minimal talar collapse. All custom-made implants are still in situ.
Protesi di prima generazione Pipino-Calderale e seconda generazione Vittore-Simone
VITTORE, Donato;
2008-01-01
Abstract
History of total ankle replacement starts in the 70s as alternative procedure to arthrodesis, with the aim to resolve pain and restore motion. Our tradition starts in 1975, five years after Lord-Marotte ankle prosthesis, with the first generation model Pipino-Calderale. Starting from this experience we realized and implanted in 1998 a second generation model, custom-made Vittore-Simone. Starting point for development of both implants is an accurate study of instantaneous centres of rotation in normal and pathologic ankles, together with a finite element analysis. The demonstration that wide resections of talar dome, modifying the geometrical arrangement of trabeculae of cancellous bone, compromise the perfect balance of uniform distribution of forces, leads us to only remove articular cartilage of talar dome instead its resection, in order to preserve the structural and vascular integrity. Our replacement doesn’t preclude an eventual arthrodesis in case of implant failure. We have a 30 years follow-up for five Pipino-Calderale models and up to 10 years for ten custom-made Vittore-Simone. Results are good for both models with satisfaction of patients and improvement of AOFAS score. Two Pipino-Calderale presented a minimal talar collapse. All custom-made implants are still in situ.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
